Why sleep assessment belongs in the memory clinic

Sleep disturbances are highly prevalent in older adults and are particularly common among individuals attending memory clinics for assessment of cognitive impairment. Emerging evidence links sleep disorders, including insomnia, obstructive sleep apnea, circadian rhythm disruption, and rapid eye movement sleep behavior disorder, to cognitive decline, neurodegenerative pathology, and reduced quality of life for patients and caregivers. Despite their high prevalence and clinical relevance, sleep disturbances are not routinely assessed within many memory clinic and neurologic, psychiatric, and geriatric settings, and approaches to screening, diagnosis, and management vary widely across health-care systems. This Perspective article examines current approaches to sleep assessment and management within memory clinic and specialized settings across four international contexts. We highlight the absence of systematic approaches to identifying and managing sleep disturbances in this population and propose the need for a pragmatic stepped-care framework to improve detection, guide referral pathways, and support more consistent and personalized care in memory clinic settings.